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Pharmacology > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What kind of bacterial skin infection calls for the use of topical cephalexin, amoxicillin/clavulanate, or dicloxacillin?

A

An S. aureus infection

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2
Q

What kind of skin infection calls for the use of topical penicillin or erythromycin?

A

A perianal streptococcal infection

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3
Q

What kind of skin infection calls for topical treatment with mupirocin, retapamulin, or OTC bacitracin?

A

Impetigo

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4
Q

Impetigo may call for the use of which combination of topical agents?

A

bacitracin and polymyxin B sulfate

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5
Q

What type of antibiotics should be used to treat cellulitis?

A

Systemic antibiotics, sometimes even parenteral before oral

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6
Q

What dermatologic conditions require systemic antibiotics?

A 
moderate to severe impetigo
boils or abcesses
perianal strep
cellulitis
suspected MRSA
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7
Q

What are the first line of topical antibiotics for skin infections?

A

Mupirocin, Retapamulin, and Bacitracin

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8
Q

What are the two medications prescribed when a double antibiotic regimen is called for?

A

bacitracin and polymixin B

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9
Q

What is the problem that many patients face when they are put on the triple topical antibiotic regimen of bacitracin, neomycin, and polymixin B?

A

Many patients develop a sensitivity to neomycin

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10
Q

At what point should an NP prescribe oral antibiotics to a patient with impetigo?

A

When there has been no improvement with topical agents after 2 to 3 days or when there are more than 5 lesions

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11
Q

Which topical antibiotics are effective against S. aureus and S. pyogenes?

A

Cephalexin
Amoxicillin/clavulanate
Dicloxacillin

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12
Q

What are the preferred antibiotics when MRSA is suspected?

A

TMP/SMZ

doxycycline

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13
Q

Retapamulin cannot not be administered through which route?

A

intranasally

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14
Q

What topical agents are normally used for a Candida infection?

A

nystatin or clomitrazole

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15
Q

What oral agent is usually used for a Candida infection?

A

fluconazole

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16
Q

What oral agent is usually prescribed for tinea capitis?

A

griseofulvin

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17
Q

Other than an oral antifungal, what treatment is usually prescribed for tinea capitis?

A

A biweekly shampoo with selenium sulfide or ketoconazole

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18
Q

What is onychomycosis and what is the treatment?

A

Fungal infection of the nail; it requires months of systemic antifungal drugs, followed by topical ciclopirox nail laquer.

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19
Q

What are the three main types of systemic antifungals?

A

Griseofulvin
-Azoles
Terbinafine (Lamisil)

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20
Q

What is the pregnancy category of most topical antifungals?

A

Pregnancy category B

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21
Q

What are the drug-drug interactions of topical versus systemic antifungals?

A

Topical have few interactions, while systemic have MANY

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22
Q

When can Gentian violet be used for Candidiasis?

A

It can be used for thrush refractory to -azoles

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23
Q

What antifungals should be used for Candidiasis?

A

Topical -azoles, nystatin

Systemic fluconazole

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24
Q

What antifungals should be used for tinnea capitus?

A

Griseofulvin, Terbinafine

selenium sulfide or ketoconazole shampoo

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25
Q

What antifungals should be used for tinea corporis (ringworm)?

A

topical -azoles
naftifine
ciclopirox olamine

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26
Q

What antifungals should be used for tinea cruris (jock itch)?

A

topical -azoles

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27
Q

What antifungals should be used for tinea pedis (athlete’s foot)?

A

topical -azoles for 4 weeks

28
Q

What antifungals should be used for tinea versicolor?

A

selenium sulfide shampoo

topical antifungal

29
Q

What lab value should be carefully monitored in all systemic antifungals?

A

Liver enzymes

30
Q

What lab values should be monitored when a patient is taking griseofulvin?

A

Renal, liver, and CBC

31
Q

What lab values should be monitored in a patient taking ketoconazole?

A

liver function

32
Q

What lab value should be monitored in a patient taking itraconazole?

A

liver function and electrolytes

33
Q

What labe values should be monitored in a patient taking terbinafine?

A

liver enzymes and CBC

34
Q

What is the drug of choice for patients with recurrent outbreaks of herpes simplex virus?

A

famciclovir or valacyclovir

35
Q

Should topical antivirals be used in herpes simplex virus outbreaks?

A

Not recommended, and only if paired with a systemic antiviral

36
Q

Which acne treatment may cause symptoms to get worse before they get better?

A

Topical retinoids

37
Q

What is the initial treatment for mild acne?

A

Benzoyl peroxide, then wait 4 to 6 weeks

38
Q

If mild acne doesn’t clear up after 4 to 6 weeks on Benzoyl peroxide, what should be added to the treatment?

A

A combined topical antibiotic or retinoid

39
Q

If a combined topical antibiotic or retinoid doesn’t improve mild to moderate acne within 6 to 8 weeks, what should the NP add to the treatment?

A

tetracycline (an oral antibiotic)

40
Q

If tetracycline doesn’t clear up moderate acne within 6 to 8 weeks, what should the NP try next?

A

minocycline (a different oral antibiotic)

41
Q

What is the treatment for Rosacea?

A

topical metronidazole (metro-gel, Noritate)

42
Q

How long does it typically take for acne and Rosacea symptoms to clear up?

A

6 to 8 weeks

43
Q

What is the drug of choice for acute exacerbations of eczema?

A

Topical corticosteroids

44
Q

Should oral corticosteroids be prescribed for eczema?

A

No

45
Q

After topical corticosteroids, what is the second line of preferred drugs for dermatitis?

A

Immunomodulators such as Pimecrolimus (Elidel) and tacrolimus (Protopic)

46
Q

What is the preferred treatment for diaper dermatitis?

A

Barrier medications such as white petroleum, zinc oxide

47
Q

What is the pregnancy category of topical immunomodulators such as Elidel and Protopic?

A

Pregnancy category C

48
Q

Who should not use topical immunomodulators such as Elidel and Protopic?

A

Children under 2 years old

49
Q

What disease state are Protopic and Elidel used for?

A

Treatment of atopic dermatitis

50
Q

If an NP does not see improvement in a patient with dermatitis, what should she do?

A

Check that the patient’s technique in applying the medication

51
Q

What systemic medications are traditionally used for the treatment of psoriasis?

A

Methotrexate
Oral retinoids
Immunosuppressants
Tumor necrosis factor blockers

52
Q

What is the traditional treatment for head lice?

A

Pyrethrins and Permethrin

53
Q

When should you retreat if there has been no improvement in a case of lice?

A

1 week

54
Q

What is the treatment for body and pubic lice?

A

Topical lindane and permethrin

55
Q

Which lice treatment is okay to use in young children and pregnant patients?

A

Pyrethrins

56
Q

If pyrethrins and permethrin do not remove lice, what is the second line treatment?

A

Topical lindane

57
Q

Should topical lindane be used in pregnant patients or infants?

A

No

58
Q

What is the most common medication used for burns in primary care?

A

Silver sulfadiazine (Silvadene)

59
Q

What is the pregnancy category of silver sulfadiazine?

A

Pregnancy category B

60
Q

What is a major ADR of silver sulfadiazine?

A

leukopenia can occur in up to 20% of patients

61
Q

What is an alternative burn treatment to silver sulfadiazine?

A

Bacitracin

62
Q

If a patient with alopecia androgenetica discontinues his treatment of topical minoxidil, what will happen?

A

Their hair will shed in 3 to 4 months

63
Q

How long does treatment of alopecia androgenetica take with topical minoxidil?

A

Full treatment effect takes 6 to 12 months

64
Q

With whom is topical minoxidil contraindicated?

A

In patients with hepatic disfunction and elevated PSA

65
Q

What is the pregnancy category of topical monoxidil?

A

Pregnancy category X

66
Q

What is a possible ADR in patients who take topical monoxidil?

A

Dermatitis

67
Q

What is a possible side effect in patients who take finasteride for alopecia androgenetica?

A

sexual dysfunction

Pharmacology (6 decks)

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